A nurse is leading a critical incident stress debriefing with a group of staff members following a mass trauma Incident. Which of the following interventions should the nurse take first?

A. Reassure staff members that the debriefing is confidential:
Explanation: Ensuring confidentiality is crucial in creating a safe space for individuals to express their emotions and thoughts freely. It builds trust among the participants, making them more likely to open up about their experiences during the debriefing session. Confidentiality encourages honest communication and helps individuals feel secure in sharing their feelings without fear of repercussions.

B. Have staff members discuss their involvement in the event:
Explanation: After establishing confidentiality, the next step is to encourage participants to discuss their involvement in the traumatic event. This can help individuals process their experiences, share their perspectives, and express their emotions related to the incident. Sharing their involvement can provide context to their reactions and emotions, facilitating a more comprehensive understanding of their experiences.

C. Ask staff members to describe their most traumatic memories of the event:
Explanation: Encouraging individuals to describe their most traumatic memories of the event is a way to help them confront and process specific experiences that might be causing distress. This step allows participants to verbalize and share their emotions and memories related to the incident. Talking about these specific memories can be therapeutic and can contribute to the overall healing process.

D. Provide stress-management exercises to the staff members:
Explanation: Providing stress-management exercises, such as relaxation techniques or breathing exercises, comes after individuals have had the opportunity to share their experiences. These exercises can help participants manage immediate stress and anxiety during the debriefing session. They provide practical tools for coping with overwhelming emotions and can be beneficial for individuals who are feeling distressed or overwhelmed during the process.

A. Instruct the client to consume a low-sodium diet to decrease hand tremors:
While maintaining a stable sodium intake is important for individuals taking lithium to avoid fluctuations in lithium levels, a low-sodium diet is not specifically indicated to address hand tremors caused by lithium. Adjusting sodium levels is more about maintaining a consistent intake to stabilize lithium levels over time.

B. Teach the client to take the lithium in a single daily dose:
Lithium is often prescribed in divided doses to maintain stable blood levels throughout the day and minimize side effects. However, the dosing regimen (once or multiple times a day) is usually determined by the healthcare provider based on the individual's needs. Changing the dosing frequency is not the primary intervention for managing hand tremors.

C. Contact the provider for a possible decrease in the lithium dosage:
Hand tremors are a common side effect of lithium. If a client is experiencing bothersome side effects within the therapeutic range, the appropriate action is to contact the healthcare provider. The provider can assess the situation, possibly adjust the dosage, or explore other management options to alleviate the tremors while maintaining the therapeutic effect of the medication.

D. Encourage the client to take naproxen sodium to decrease tremors:
Encouraging the client to take naproxen sodium or any other nonsteroidal anti-inflammatory drug (NSAID) is not recommended when the client is on lithium therapy. NSAIDs can interact with lithium, potentially leading to increased lithium levels and toxicity. Combining these medications should be avoided.